Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Denetra Johnson

Individual provider Family Nurse Practitioner · NPI 1205207388

Denetra Johnson is a Nurse Practitioner in Stockbridge, Georgia. Qualified in 2014, 12 years ago. Practices with Acs Primary Care Physicians - Southeast PC, a 410-clinician group and accepts Medicare assignment. Licensed in Georgia and Mississippi.

Years since qualifying
12
Licensed in
GA, MS
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

5095 Mount Zion Pkwy
Stockbridge, GA 30281-7825
Phone: (401) 652-9787
Fax: (401) 652-9787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN161105 (GA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence R865978 (MS)

Record details

NPI number1205207388
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 14, 2015
Last updated in NPPESOctober 10, 2025
Certification dateOctober 10, 2025
Mailing address5095 Mount Zion Pkwy, Stockbridge, GA 30281-7825

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Acs Primary Care Physicians - Southeast Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Stockbridge